关键词: 结核, 获得性免疫缺陷综合征, 重叠感染, 普查

Abstract: Objective To compare the effects of HIV screening for TB patients in different HIV epidemic area.  Methods Three hundred and thirty-three counties in 31 provinces (cities, districts) were sampled with stratified cluster sampling method. The survey was divided into two stages. New registered TB patients were offered HIV antibody testing during September 1st to December 31st in 2007 and 2008 respectively. A total of 45 675 TB patients were surveyed. Results The new HIV detection rate in TB patients was 0.3% (133/43 998). Of new diagnosed HIV-positive cases, 70.7% (94/133) came from nine southwest provinces, 20.3% (27/133) came from seven central provinces. It was more likely to detect new HIV-positive cases in TB patients in provinces with the cumulative reporting number of HIV/AIDS cases more than or equal to 6000 than in provinces with that less than 2000 (0.6%（98/15 872） vs 0.1%（13/13 302），OR=6.35，95%CI=3.56－11.33), in counties with that more than or equal to 200 than in counties with that less than 50 (0.6%（70/11 521） vs 0.1%（20/22 656），OR=6.92，95%CI=4.21－11.38), and in counties with that more than or equal to 50 but less than 200 than in counties with that less than 50 (0.4%（43/9821） vs 0.1%（20/22 656），OR=4.98，95%CI=2.93－8.47). Conclusion HIV screening strategy for TB patients should be developed according to the severity and characteristics of local HIV epidemic. Routine HIV testing for TB patients should be implemented in counties with the cumulative reporting number of HIV/AIDS cases more than or equal to 200 in central China where HIV transmission route was mainly through illegal blood transfusion, and in counties with that more than or equal to 50 in other area.

Key words: Tuberculosis, Acquired immunodeficiency syndrome, Superinfection, Mass screening